CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER

LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG

BULAN : JANUARI 2022
SERIAL : LEVEL 1
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - - - - - - - - - - - - -

URO Normal - - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020

PH 5.5-7.0 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5
BULAN : JANUARI 2022
SERIAL : LEVEL 2
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - - - - - - - - - - - - -

URO 64-128umol/L 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100

KET Trace-4.0 mmol/L 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

NIT Positive 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 115 70 70 70 70 70 70 70 70 70 70 70 70 70 115 156 70 70 70 70 70

GLU 30-60 mmol/L 56 50 35 56 35 30 50 50 56 50 30 50 50 56 50 50 50 50 50 50 50

SG 1.010-1.025 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020
PH 6.0-7.5 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : FEBRUARI 2022
SERIAL : LEVEL 1
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
VC 0 - - - - - - - - - - - - - - - - - - - -

URO Normal - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020

PH 5.5-7.0 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5
BULAN : FEBRUARI 2022
SERIAL : LEVEL 2
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
VC 0 - - - - - - - - - - - - - - - - - - - -

URO 64-128umol/L 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100

KET Trace-4.0 mmol/L 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

NIT Positive 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 115 70 70 70 70 70 70 115 113 70 70 70 115 113 70 70 70 70 70 75

GLU 30-60 mmol/L 56 50 35 56 50 50 56 35 35 50 50 56 56 56 50 50 56 50 50 56

SG 1.010-1.025 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020
PH 6.0-7.5 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : MARET 2022
SERIAL : LEVEL 1
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - - - - - - - - - - - - - -

URO Normal - - - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020

PH 5.5-7.0 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5

BULAN : MARET 2022

SERIAL : LEVEL 2
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - - - - - - - - - - - - - - -

URO 64-128umol/L 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100

KET Trace-4.0 mmol/L 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

NIT Positive 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 115 70 70 70 125 115 70 70 70 125 115 70 70 70 110 115 70 70 70 115 70 70 70

GLU 30-60 mmol/L 56 50 35 56 35 56 50 35 56 35 56 50 35 56 35 56 50 35 56 56 50 35 56

SG 1.010-1.025 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020

PH 6.0-7.5 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : APRIL 2022
SERIAL : LEVEL 1
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
VC 0 - - - - - - - - - - - - - - - - - - - -

URO Normal - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020

PH 5.5-7.0 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5 5,5
BULAN : APRIL 2022
SERIAL : Level 2
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
VC 0 - - - - - - - - - - - - - - - - - - - -

URO 64-128umol/L 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131 131

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100

KET Trace-4.0 mmol/L 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0 4,0

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

NIT Positive 2 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 15 125 115 70 70 70 70 70 70 70 70 70 70 70 155 70 70 70 70 70

GLU 30-60 mmol/L 28 35 56 50 35 56 35 56 50 35 56 35 50 50 50 35 30 35 30 35

SG 1.010-1.025 1.02 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020

PH 6.0-7.5 6 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : MEI 2022
SERIAL : LEVEL 1
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - -

URO Normal - - - - - - - - - -

BIL Negatif - - - - - - - - - -

KET Negatif - - - - - - - - - -

BLD Negatif - - - - - - - - - -

PRO Negatif - - - - - - - - - -

NIT Negatif - - - - - - - - - -

LEU Negatif - - - - - - - - - -

GLU Negatif - - - - - - - - - -

SG 1.010-1.020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020

PH 5.5-7.0 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5
BULAN : MEI 2022
SERIAL : LEVEL 2
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - -

URO 64-128umol/L 66 115 66 66 66 66 113 113 66 66

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100

KET Trace-4.0 mmol/L 1.5 0.5 0.5 0.5 1.5 1.5 1.5 0.5 1.5 1.5

BLD 80-200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 3 3 3 1,0 3,0 1,0 1,0 1,0 3,0 1,0

NIT Positive 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 125 115 70 70 70 70 115 70 70 125

GLU 30-60 mmol/L 35 35 35 35 35 56 50 56 35 30

SG 1.010-1.025 1,025 1,025 1,025 1,025 1,020 1,020 1,020 1,020 1,020 1,020

PH 6.0-7.5 6.5 6.5 7,0 7,0 6.5 6,0 6.5 6.5 6.5 6.5
Keterangan : Tanda Merah tidak dilakukan kontrol karena reagen habis dan tidak dilakukan pemeriksaan terhadap sampel.
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : JUNI 2022
SERIAL : LEVEL 1
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
VC 0 - - - - - - - - - - - - - - - - - - - - -

URO Normal - - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020

PH 5.5-7.0 5.5 5.5 5.5 5.5 5.5 5.5 5,0 5,0 5.5 5.5 5.5 5.5 6,0 6,0 6,0 6,0 6,0 5.5 5.5 6,0 6.5
BULAN : JUNI 2022
SERIAL : LEVEL 2
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
VC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

URO 64-128umol/L 66 66 66 66 115 66 66 113 66 66 66 115 100 66 66 66 66 66 100 66 66

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100
Trace-4.0
KET mmol/L
1.5 1.5 1.5 1.5 1.5 0.5 1.5 1.5 0.5 1.5 0.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 1,0 1,1 1,0 1,0 1,0 0.3 1,0 1,0 1,0 1,0 1,0 1,0 1,0 3,0 1,0 1,0 1,0 1,0 1,0 1,0 1,0

NIT Positive 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 70 70 70 70 70 115 133 70 70 70 70 70 70 70 70 70 70 70 70 70 70

GLU 30-60 mmol/L 50 56 35 50 46 56 56 35 35 35 33 33 56 56 56 56 56 30 30 30 56

SG 1.010-1.025 1,025 1,020 1,020 1,030 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020

PH 6.0-7.5 6.5 7.5 6.5 6,0 6.5 5,0 6.5 6.5 6,0 6.5 6.5 6.5 6,0 6.5 6.5 6,0 6.5 6.5 6,0 7,0 6.5
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : JULI 2022
SERIAL : NORMAL
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

URO Normal - - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1.025 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020 1.020

PH 5.5-7.0 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5
BULAN : JULI 2022
SERIAL : ABNORMAL
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

URO 64-128umol/L 33 33 33 33 33 33 33 33 33 33 33 66 33 66 66 66 66 33 33 33 33

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100
Trace-4.0
KET mmol/L
1.5 1.5 1.5 1.5 1.5 1.5 4.0 4.0 1.5 1.5 1.5 1.5 0.5 0.5 0.5 1.5 4.0 1.5 0.5 0.5 1.5

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 3.0 3.0 1.0 1.0 1.0 1.0 3.0 3.0 1.0 1.0 1.0 1.0 3.0 1.0 3.0 1.0 1.0 3.0 1.0 3.0 1.0

NIT Positive 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 70 70 15 15 15 70 15 70 70 15 70 70 15 70 70 70 15 70 15 125 70

GLU 30-60 mmol/L 28 28 28 28 28 28 28 28 28 28 28 28 14 28 28 28 14 28 28 28 56

SG 1.010-1.025 1.02 1.020 1.025 1.020 1.020 1.020 1.020 1.025 1.020 1.020 1.020 1.020 1.025 1.020 1.020 1.020 1.025 1.025 1.020 1.020 1.020

PH 6.0-7.5 6.5 6.5 6.0 6.5 6.5 6.0 6.5 6.0 6.5 6.5 6.0 6.5 6.0 6.5 6.5 6.0 6.5 6.0 6.5 6.5 6.0
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : AGUSTUS 2022
SERIAL : NORMAL
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - - - - - - - - - - - - - -
URO Normal - - - - - - - - - - - - - - - - - - - - - -
BIL Negatif - - - - - - - - - - - - - - - - - - - - - -
KET Negatif - - - - - - - - - - - - - - - - - - - - - -
BLD Negatif - - - - - - - - - - - - - - - - - - - - - -
PRO Negatif - - - - - - - - - - - - - - - - - - - - - -
NIT Negatif - - - - - - - - - - - - - - - - - - - - - -
LEU Negatif - - - - - - - - - - - - - - - - - - - - - -
GLU Negatif - - - - - - - - - - - - - - - - - - - - - -
SG 1.010-1.020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020
PH 5.5-7.0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,5 5,0 5,0 5,0 5,0 5,0
BULAN : AGUSTUS 2022
SERIAL : ABNORMAL
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
URO 64-128umol/L
66 33 33 33 66 66 131 131 131 66 66 131 66 131 66 66 66 66 66 33 33 33
BIL 2.0-100umol/L
100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100
Trace-4.0
KET mmol/L 1,5 1,5 1,5 1,5 4 1,5 1,5 1,5 1,5 4 1,5 1,5 1,5 1,5 1,5 1,5 1,5 1,5 0,5 1,5 1,5 0,5
BLD 80-200
200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200
PRO Trace-3 g/L
3,0 1,0 1,0 1,0 1,0 3,0 3,0 3,0 3,0 1,0 3,0 3,0 3,0 3,0 1,0 3,0 3,0 1,0 0,3 1,0 0,15 0,3
NIT Positive
2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+
LEU 70-500
70 70 15 15 70 15 70 70 125 70 70 125 70 70 70 15 70 15 15 70 70 15
GLU 30-60 mmol/L
28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28
SG 1.010-1.025
1,020 1,025 1,025 1,025 1,020 1,020 1,020 1,020 1,025 1,020 1,020 1,021 1,020 1,021 1,020 1,020 1,020 1,020 1,025 1,020 1,025 1,025
PH 6.0-7.5
5,5 6,0 5,5 6,0 5,5 6,0 5,0 6,0 5,5 6,5 6,0 6,5 6,5 6,5 6,5 5,5 6,0 5,0 6,5 6,5 6,5 5,5
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : SEPTEMBER 2022
SERIAL : NORMAL
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
VC 0 - - - - - - - - - - - - - - - - - - - - - -
URO Normal - - - - - - - - - - - - - - - - - - - - - -
BIL Negatif - - - - - - - - - - - - - - - - - - - - - -
KET Negatif - - - - - - - - - - - - - - - - - - - - - -
BLD Negatif - - - - - - - - - - - - - - - - - - - - - -
PRO Negatif - - - - - - - - - - - - - - - - - - - - - -
NIT Negatif - - - - - - - - - - - - - - - - - - - - - -
LEU Negatif - - - - - - - - - - - - - - - - - - - - - -
GLU Negatif - - - - - - - - - - - - - - - - - - - - - -
SG 1.010-1.020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020 1,020
PH 5.5-7.0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0
BULAN : SEPTEMBER 2022
SERIAL : ABNORMAL
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
VC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

URO 64-128umol/L 66 33 66 33 33 33 66 66 33 33 33 66 66 33 33 33 66 66 33 33 33 66

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100
Trace-4.0
KET mmol/L
1,5 1,5 1,5 1,5 1,5 1,5 4 1,5 1,5 1,5 1,5 4 1,5 1,5 1,5 1,5 4 1,5 1,5 1,5 1,5 4

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 3,0 1,0 3,0 1,0 1,0 1,0 1,0 3,0 1,0 1,0 1,0 1,0 3,0 1,0 1,0 1,0 1,0 3,0 1,0 1,0 1,0 1,0

NIT Positive 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 70 70 70 70 15 15 70 70 70 15 15 70 70 70 15 15 70 70 70 15 15 70

GLU 30-60 mmol/L 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28

SG 1.010-1.025 1,020 1,025 1,020 1,025 1,025 1,025 1,020 1,020 1,025 1,025 1,025 1,020 1,020 1,025 1,025 1,025 1,020 1,020 1,025 1,025 1,025 1,020

PH 6.0-7.5 5,5 6,0 5,5 6,0 5,5 6,0 5,5 5,5 6,0 5,5 6,0 5,5 5,5 6,0 5,5 6,0 5,5 5,5 6,0 5,5 6,0 5,5
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : OKTOBER 2022
SERIAL : NORMAL
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - - - - - - - - - - - - -

URO Normal - - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1.020 1.020 1.025 1.025 1.020 1.025 1.025 1.020 1.025 1.020 1.025 1.030 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025

PH 5.5-7.0 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5
BULAN : OKTOBER 2022
SERIAL : ABNORMAL
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

URO 64-128umol/L 66 66 66 33 33 131 66 66 66 131 131 131 33 33 33 66 66 66 66 66 66

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100
Trace-4.0
KET mmol/L
1.5 0.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 0.5 1.5 0.5 1.5 1.5 1.5 1.5 1.5

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 1.0 1.0 1.0 1.0 3.0 1.0 1.0 1.0 1.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0

NIT Positive 2+ 2+ 2+ 1+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 70 70 125 70 70 125 70 70 70 70 15 70 70 70 70 70 70 70 70 70 70

GLU 30-60 mmol/L 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28

SG 1.010-1.025 1.025 1.025 1.025 1.025 1.025 1.020 1.020 1.025 1.030 1.020 1.025 1.025 1.025 1.025 1.025 1.030 1.025 1.025 1.025 1.025 1.025

PH 6.0-7.5 5.5 5.5 5.5 6.0 6.0 6.0 6.0 6.0 6.0 5.5 5.0 6.0 6.0 5.0 6.0 5.0 6.0 6.0 5.0 5.5 5.5
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : OKTOBER 2022
SERIAL : NORMAL
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
VC 0 - - - - - - - - - - - - - - - - - - - - - -

URO Normal - - - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1.025 1.025 1.025 1.030 1.030 1.030 1.030 1.030 1.030 1.025 1.025 1.025 1.025 1.025 1.030 1.030 1.025 1.030 1.030 1.030 1.030 1.030

PH 5.5-7.0 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5
BULAN : OKTOBER 2022
SERIAL : ABNORMAL
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
VC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

URO 64-128umol/L 33 33 131 66 33 33 33 131 131 131 66 131 131 131 66 66 131 33 131 131 131 131

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100
Trace-4.0
KET mmol/L
1.5 0.5 1.5 1.5 0.5 1.5 1.5 1.5 1.5 1.5 0.5 1.5 1.5 1.5 1.5 1.5 0.5 0.5 1.5 1.5 1.5 1.5

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 1.0 1.0 1.0 0.3 1.0 1.0 0.3 0.3 0.3 1.0 1.0 1.0 1.0 0.3 1.0 1.0 1.0 1.0 0.3 1.0 1.0 0.3

NIT Positive 2+ 2+ 2+ 1+ 1+ 1+ 2+ 1+ 1+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 70 70 70 15 15 70 125 70 70 70 15 70 70 70 70 70 15 70 70 70 70 70

GLU 30-60 mmol/L 28 28 28 14 15 15 15 125 125 28 28 28 28 28 50 56 28 28 28 28 28 28

SG 1.010-1.025 1.020 1.025 1.025 1.030 1.030 1.030 1.030 1.025 1.025 1.025 1.025 1.025 1.030 1.025 1.025 1.025 1.025 1.030 1.025 1.025 1.030 1.025

PH 6.0-7.5 6.0 6.0 6.0 6.0 6.0 6.0 6.0 6.0 6.0 6.0 6.0 6.0 6.0 6.5 6.0 6.0 6.0 7.0 6.5 6.0 6.0 6.5
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : DESEMBER 2022
SERIAL : NORMAL
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - - - - - - - - - - - - - -

URO Normal - - - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1.025 1.025 1,030 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025

PH 5.5-7.0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5,0
BULAN : DESEMBER 2022
SERIAL : ABNORMAL
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

URO 64-128umol/L 131 131 131 66 131 131 131 131 66 131 131 131 66 66 66 66 33 131 1131 33 66 33

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 33 100 100 100 100 100
Trace-4.0
KET mmol/L
1.5 1.5 0.5 1.5 1.5 1.5 1.5 1.5 0.5 1.5 1.5 1.5 1.5 1.5 1,0 1.5 0.5 1.5 1.5 1.5 0.5 1.5

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 80 200 200 200 200 200

PRO Trace-3 g/L 1,0 0.15 3,0 1,0 1,0 3,0 3,0 1,0 0.3 1,0 1,0 1,0 1,0 1,0 0.15 0.3 0.3 1,0 0.3 0.3 1,0 1,0

NIT Positive 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 70 70 70 70 70 70 70 70 70 15 15 70 15 70 15 70 70 0 70 70 15 70

GLU 30-60 mmol/L 28 14 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28

SG 1.010-1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025

PH 6.0-7.5 6,0 6,0 6,0 6,0 5.5 6,0 6,0 6.5 6.5 6,0 6,0 6,0 6,0 6.5 6,0 6.5 5.5 6,0 6.5 6.5 6.5 6.5
 CHECKLIST PEMANTAPAN MUTU INTERNAL URINE-ANLYZER
LABORATORIUM BLUD PUSKESMAS KECAMATAN MENTENG
BULAN : JANUARI 2023
SERIAL : NORMAL
NO. LOT : 87721
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 - - - - - - - - - - - - - - - - - - - - -

URO Normal - - - - - - - - - - - - - - - - - - - - -

BIL Negatif - - - - - - - - - - - - - - - - - - - - -

KET Negatif - - - - - - - - - - - - - - - - - - - - -

BLD Negatif - - - - - - - - - - - - - - - - - - - - -

PRO Negatif - - - - - - - - - - - - - - - - - - - - -

NIT Negatif - - - - - - - - - - - - - - - - - - - - -

LEU Negatif - - - - - - - - - - - - - - - - - - - - -

GLU Negatif - - - - - - - - - - - - - - - - - - - - -

SG 1.010-1.020 1.025 2.025 3.025 1,030 1.025 1.025 2.025 3.025 4.025 1.025 1.025 2.025 3.025 1.025 1.025 2.025 3.025 1.025 1.025 1.025 2.025

PH 5.5-7.0 5,0 5,1 5,2 5,0 5,0 5,0 5,1 5,2 5,3 5,0 5,0 5,1 5,2 5,0 5,0 5,0 5,0 5,0 5,0 5,0 5.5
BULAN : JANUARI 2023
SERIAL : ABNORMAL
NO. LOT : 87722
Tanggal
Parameter Range
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
VC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

URO 64-128umol/L 33 33 33 66 131 66 66 66 33 60 33 131 66 66 66 33 33 131 1131 33 33

BIL 2.0-100umol/L 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100
Trace-4.0
KET mmol/L
1.5 1.5 1.5 0.5 1.5 1.5 1.5 1.5 1.5 0.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5

BLD 80-200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

PRO Trace-3 g/L 0.15 0.15 0.15 3,0 1,0 3,0 3,0 3,0 1,0 0.3 1,0 1,0 3,0 1,0 1,0 1,0 1,0 1,0 0.3 1,0 1,0

NIT Positive 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+

LEU 70-500 70 70 70 70 70 70 70 70 70 70 70 70 70 15 70 70 70 0 70 70 70

GLU 30-60 mmol/L 14 14 14 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28 28

SG 1.010-1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1,030 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025 1.025

PH 6.0-7.5 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6,0 6.5 6.5 6,0 6.5 6,0 6,0 6.5 6,0 6,0 6,0 6.5 6.5 6,0